Evidence Table 1

Diagnosis and Consultations Using Telehealth

SourceSafety Issue Related to Clinical PracticeDesign TypeStudy Design & Study Outcome Measure(s)Study Setting & Study PopulationStudy InterventionKey Finding(s)Category of Telehealth Article O = Outcomes M = Monitoring D = Diagnosis/Consultation T = Technical/Ethical
Belachel 200511Web-based clinical decision support toolChanging practice projects/researchObservational study with controls (Level 3) Other measurable variables with an indirect or unestablished connection to the target safety outcome (Level 3)191 Acute leukemia cases from the database of Cliniques Universitaires Saint- Luc Brussels, BelgiumWeb-based clinical decision support tool to virtually diagnose and support secure and timely electronic data exchange regarding acute leukemia.The percentage of correct classification in this experimental testing was consistent with the proposed prototype. 96.4% of acute leukemia cases were correctly classified, proving that Web integration can be a promising tool for dissemination of computerized decision support system tools. The system is robust and capable of deployment for referring physicians.D
Schwaab 200510The study compared the accuracy of a 12- lead electrocardiogram (ECG) recorded by patients and transmitted to a cardiology call center via telephone (tele- ECG) with standard 12-lead ECGs.Non- randomized trialsNonrandomized control trials (Level 2) Surrogate outcomes (Level 2)158 post myocardial infarction cardiac patients living at home with the capacity to communicate the tele- ECG via telephone.Tele-ECGs were compared with standard ECGs by two cardiologists and one internist, independently and blindly.In 155 of 158 patients (98%), the quality of the tele-electrocardiogram (tele-ECG) was adequate for diagnosis. Reliability coefficients ® for PQ, QRS, and QT intervals between tele- and standard ECG. Additionally, negative T- waves and ST segment detection was very good. Residual signs of myocardial infarction could be detected by tele-ECG, with very good agreement for anterior as well as for posterior localizations. The tele-ECG technique seems a promising approach to reducing pre- and in- hospital time delays to the initiation of thrombolytic therapy.D

From: Chapter 48, Patient Safety, Telenursing, and Telehealth

Cover of Patient Safety and Quality
Patient Safety and Quality: An Evidence-Based Handbook for Nurses.
Hughes RG, editor.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.